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Management of neurotrauma during COVID-19: a single centre experience and lessons for the future

Manivannan, S., Sharouf, F., Mayo, I., Albaqer, H., Mehrez, M., Jaber, H., Nicholls, Z., Woodward, B. O., Watkins, W. J. and Zaben, M. 2021. Management of neurotrauma during COVID-19: a single centre experience and lessons for the future. Brain Injury 10.1080/02699052.2021.1934731
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Abstract

Introduction: Traumatic brain injury (TBI) is amongst the leading causes of morbidity and mortality worldwide. The unprecedented emergence of COVID-19 has mandated neurosurgeons to limit viral spread and spare hospital resources whilst trying to adapt management plans for TBI. We aimed to characterize how this affects decision-making on TBI management and drive strategies to cope with future expected waves. Methods: Retrospective TBI data collection from a single tertiary referral unit was performed between: 01/04/2019 – 30/06/2019 (‘Pre-Epidemic’) and 01/04/2020 – 30/06/20 (‘Epidemic’). Demographics, mechanism of injury, TBI severity, radiological findings, alcohol/anticoagulants/antiplatelets use, and management decisions were extracted. Results: 646 TBI referrals were received in ‘Pre-Epidemic’ (N = 317) and ‘Epidemic’ (N = 280) groups. There was reduction in RTA-associated TBI (14.8 vs 9.3%; p = .04) and increase in patients on anticoagulants (14.2 vs 23.6%; p = .003) in the ‘Epidemic’ group. Despite similarities between other TBI-associated variables, a significantly greater proportion of patients were managed conservatively in local referring units without neurosurgical services (39.1 vs 56.8%; p < .0001), predominantly constituted by mild TBI. Conclusion: Despite COVID-19 public health measures, the burden of TBI remains eminent. Increases in local TBI management warrant vigilance from primary healthcare services to meet post-TBI needs in the community.

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Taylor & Francis: STM, Behavioural Science and Public Health Titles
ISSN: 0269-9052
Date of First Compliant Deposit: 26 May 2021
Date of Acceptance: 21 May 2021
Last Modified: 08 Jul 2021 10:32
URI: http://orca.cardiff.ac.uk/id/eprint/141577

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